Tag: 1115 waiver

Last month the North Carolina Department of Health and Human Services (DHHS) submitted an amendment to the 1115 demonstration waiver application, originally submitted in June 2016. This amendment is the next step in the transformation of NC Medicaid and NC Health Choice programs to managed care, driving the state’s goal to implement reform. This system will address both the physical and behavioral health of North Carolinians. The proposed program design seeks to implement changes that advances high-value care, improves population health, engages and supports providers, and establishes a sustainable program with predictable costs. Our BAYADA workgroup, made up of technical experts and leadership from across the organization, has reviewed and provided formal comments to both the program design and waiver application. Our comments focus on: ensuring beneficiary access to care; the viability of the provider network; minimizing administrative burden, and establishing meaningful metrics that support and reward quality.

Special thanks to our review BAYADA teams for sharing their insight and operational experience.